Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review
Abstract Background The preferable choice of anesthesia for the patients with congenital atlantoaxial dislocation (CAAD) and type I Arnold Chiari malformations (ACM-I) has been a very confusing issue in clinical practice. We describe the successful administration of combined spinal-epidural anesthes...
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doaj-4edbc799052a45faaaea1593309319ad2021-04-04T11:17:44ZengBMCBMC Pregnancy and Childbirth1471-23932021-04-012111510.1186/s12884-021-03751-3Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature reviewYuyan Nie0Weimin Zhou1Shaoqiang Huang2Department of Anesthesiology, The Obstetrics and Gynecology Hospital of Fudan UniversityDepartment of Anesthesiology, Anyang Maternity and Child Care CenterDepartment of Anesthesiology, The Obstetrics and Gynecology Hospital of Fudan UniversityAbstract Background The preferable choice of anesthesia for the patients with congenital atlantoaxial dislocation (CAAD) and type I Arnold Chiari malformations (ACM-I) has been a very confusing issue in clinical practice. We describe the successful administration of combined spinal-epidural anesthesia for a woman with CAAD and ACM-1 accompanied by syringomyelia. Case presentation Our case report presents the successful management of a challenging obstetric patient with CAAD and ACM-1 accompanied by syringomyelia. She had high risks of difficult airway and aspiration. The injection of bolus drugs through the spinal or epidural needle may worsen the previous neurological complications. The patient was well evaluated with a multidisciplinary technique before surgery and the anesthesia was provided by a skilled anesthesiologist with slow spinal injection. Conclusions An interdisciplinary team approach is needed to weigh risks and benefits for patients with CAAD and ACM-1 undergoing cesarean delivery. Therefore, an individual anesthetic plan should be made basing on the available anesthetic equipments and physicians’ clinical experience on anesthetic techniques.https://doi.org/10.1186/s12884-021-03751-3Anesthetic managementCongenital atlantoaxial dislocation Arnold–Chiari malformationCesarean sectionSyringomyelia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuyan Nie Weimin Zhou Shaoqiang Huang |
spellingShingle |
Yuyan Nie Weimin Zhou Shaoqiang Huang Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review BMC Pregnancy and Childbirth Anesthetic management Congenital atlantoaxial dislocation Arnold–Chiari malformation Cesarean section Syringomyelia |
author_facet |
Yuyan Nie Weimin Zhou Shaoqiang Huang |
author_sort |
Yuyan Nie |
title |
Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review |
title_short |
Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review |
title_full |
Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review |
title_fullStr |
Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review |
title_full_unstemmed |
Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review |
title_sort |
anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and chiari type i anomaly: a case report and literature review |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-04-01 |
description |
Abstract Background The preferable choice of anesthesia for the patients with congenital atlantoaxial dislocation (CAAD) and type I Arnold Chiari malformations (ACM-I) has been a very confusing issue in clinical practice. We describe the successful administration of combined spinal-epidural anesthesia for a woman with CAAD and ACM-1 accompanied by syringomyelia. Case presentation Our case report presents the successful management of a challenging obstetric patient with CAAD and ACM-1 accompanied by syringomyelia. She had high risks of difficult airway and aspiration. The injection of bolus drugs through the spinal or epidural needle may worsen the previous neurological complications. The patient was well evaluated with a multidisciplinary technique before surgery and the anesthesia was provided by a skilled anesthesiologist with slow spinal injection. Conclusions An interdisciplinary team approach is needed to weigh risks and benefits for patients with CAAD and ACM-1 undergoing cesarean delivery. Therefore, an individual anesthetic plan should be made basing on the available anesthetic equipments and physicians’ clinical experience on anesthetic techniques. |
topic |
Anesthetic management Congenital atlantoaxial dislocation Arnold–Chiari malformation Cesarean section Syringomyelia |
url |
https://doi.org/10.1186/s12884-021-03751-3 |
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